This document discusses the importance of play for children in the hospital. It begins by explaining how play is crucial for children's development and helps them learn and grow physically, cognitively, and socially. While play comes naturally for most children, hospitalized children rely on support from staff like child life specialists to engage in play. The document then reviews research showing that both medical play, using hospital equipment, and normative play benefit hospitalized children. Studies found medical play helped reduce children's anxiety about procedures by familiarizing them beforehand. The document advocates for supporting play in hospitals to allow children's normal development and reduce stress during treatment.

1. Running head: HDFS 2950 PLAY IN THE HOSPITAL 1
The Importance of Play in the Hospital
Allyson Smith
University of Georgia

2. HDFS 2950 PLAY IN THE HOSPITAL 2
Introduction
Play is a crucial part of development for children. From infancy throughout the later stages
of childhood, play guides children in learning about themselves and the world around them. The
development of children who are unable to play suffers. For most children play is easy to
achieve, however for those that are hospitalized play occurs with the support of hospital staff
(including child life specialists) and caretakers. In recent years, the importance of both medical
play (play with medical equipment) and normative play in the hospital have been recognized.
Play is imperative for hospitalized children because of its connection to physical, cognitive, and
socio-emotional growth.
Background
The importance of play within the hospital is a relatively new discovery. According to
Gerber (2012), it was not until 1986 that a child life certification became available. Before that
Wheelock College at Boston University offered education on play within the hospitals in the late
sixties and early seventies (Gerber, 2012). In the year 1978 a child life specialty degree was
officially offered (Gerber, 2012). With this being said, the field of child life and play within the
hospital is still taking on new developments. Over the years play within the hospital has changed
to accompany new methods of play as well as new medical advances. In particular medical play
within the hospital has been adjusted to more effectively teach children about the equipment
being used in their procedures.
Research
There have been multiple studies conducted on the importance of play (both normative and
medical) within the hospital for developing children. Most studies conducted in this field are
longitudinal and qualitative. Longitudinal studies are conducted over time. Qualitative studies

3. HDFS 2950 PLAY IN THE HOSPITAL 3
are conducted studying observable traits. In this field most studies are done by observing
children in the hospital over time and the effects play has on their emotional well-being.
In studies conducted on medical play most researchers studied the effect familiarizing
children with medical equipment had on children’s feelings about medical procedures. In one
study conducted by Huff and Mcgrath, (2008) healthy children were exposed to medical play in
order to compare their methods of play with children who were diagnosed with leukemia. The
study found that children who had previous medical experience, whether it be personal or
through a sibling or parent and were not first exposed to medical equipment, were a lot less
comfortable playing with the medical equipment then children who did not have previous
experience. Similar observations were made in an experiment conducted by researchers Bloch
and Toker (2008) called “Teddy Bear Hospital.” In this experiment children brought a teddy bear
to a hospital or doctor’s office a few days before their own doctor or hospital visit. The teddy
bear would then undergo the same procedures and treatments that the child would undergo a few
days later. Children who had brought their teddy bear in for the “procedure” were found to be
significantly less anxious than children who did not. These studies along with others helps
emphasize the importance that pre-exposing children to medical equipment can help ease some
of their anxieties and fears about upcoming procedures.
The research conducted on normative play is mainly compiled of case studies. In one
conducted by Kuntz (1996) it was observed that after a play schedule was created for a patient in
the hospital the patients sleep in the middle of the day decreased, random acts of boredom
decreased, and social interactions increased. Studies like this help prove the direct benefits
normative play has on a patient’s experience in the hospital.
Application

4. HDFS 2950 PLAY IN THE HOSPITAL 4
Play is a driving factor in all types of development and therefore can be found in most
theories of development. Play influences physical development through development of new fine
and gross motor skills (Berk & Meyers, 2017). Cognitive development is developed with play
throughout Piaget’s stages. Finally, play encourages children to build social relationships as well
as helps guide Erikson’s stages.
Physical play can be seen as early as the infant years. Infants grasp and grab at toys and
while doing so develop fine motor skills, or skills that use smaller movements. Throughout later
development toys help to further develop hand movements. For example, within the hospital
children can be given paints or writing utensils as a way to work on their fine motor skills. On a
larger scale play helps children to develop gross motor skills, or skills that help children move
around in the environment. An example of gross motor play within the hospital would be a
playground. In a hospital it is very easy for children to become bound to their own room or bed,
however, if children are encouraged to play and move around outside of their bed then both fine
and gross motor skills can continue to develop at a normal pace.
Throughout Piaget’s stages, play helps guide cognitive development. Starting with the
sensorimotor stage, toys are used to help infants learn about object permanence. In the
preoperational stage pretend play helps children to practice and strengthen newly learned
schemes. The concrete operational stage uses play to develop more logical, flexible, and
organized thoughts. Finally, the formal operational stage helps children to form abstract
thoughts. Within the hospital cognitive play can be seen through children being able to play dress
up in the preoperational stage or playing board games within the concrete operational stage. It is
important during hospitalization that children are continuously challenged and played with so
that development continues normally (Mcleod, 2018).

5. HDFS 2950 PLAY IN THE HOSPITAL 5
Children in the hospital are often times not able to be social as they may like. Without the
ability to be social, it is harder for children within the hospital to create forms of secure
attachment with the hospital staff or even with their caretakers. Play however allows children to
create bonds with hospital staff and other patients that helps in both their social-emotional
development and their healing process. Throughout Erikson’s stages, play is seen as a way to
overcome each challenge. For example, in Erikson’s fourth stage, industry vs. inferiority children
develop a positive and realistic self-concept. This self-concept is built through children
mastering useful skills and tasks (Mcleod, 2018). While a child in the hospital may not be able to
learn many new skills and tasks, play allows them to do things they may not ordinarily be able to
do. Play also helps children to process the different emotions they may be feeling in the hospital
such as fear, anger, and frustration. One example of this is seen through Schneider Children’s
Medical Center of Israel (2003). Clay and painting were both used as outlets at Schneider’s to
express how children feel during treatment. Clay and painting also make it easier for children to
talk to adults about what they are experiencing. At difficult times, such as an extended stay in the
hospital, it becomes increasingly important that children are able to effectively communicate
their feelings and emotions. Play allows for them to do this.
When working with children in the hospital it is important to remember that they often feel
that they have no control over what they are going through. Play is a good escape from these
feelings. As long as play is at an appropriate age level it guides children in all types of normative
development.
Call to Action
It is important for communities to note the difference that play makes for children who are
hospitalized. Communities can help children to play in the hospital by donating toys, art

6. HDFS 2950 PLAY IN THE HOSPITAL 6
supplies, etc. to local children’s hospitals. Schools can also help by hosting donation drives.
Volunteers can volunteer their time at local hospitals to play with children and make their stay
better. Volunteers can also help organize new toys and supplies for this hospital. Researchers can
continue to observe the difference in children who play versus those who do not. Researchers can
also continue to develop new ways for children to play within the hospital.
Being in the hospital as a child can be a terrifying experience. There are new people, new
equipment, and most of the time the child may not fully understand what is going on. One of the
goals of a hospital is to help children feel as normal as positive. Play allows for this to happen.
Play allows for normal physical, cognitive, and social emotional development. It allows for
social connections to form between patients and others. It also helps children to ease some of the
feelings of fear and anxiety they may have. Play is a part of childhood that should not be taken
away from a child because of hospitalization.

7. HDFS 2950 PLAY IN THE HOSPITAL 7
References
Berk, L. E. (2016). Infants, children, and adolescents. Boston, MA: Allyn and Bacon.
Bloch, Y. H., & Toker, A. (2008). Doctor, is my teddy bear okay? The “Teddy Bear Hospital” as
a method to reduce children’s fear of hospitalization. Israel Medical Association
Journal, 10(8-9), 597-599. Retrieved from
https://www.ima.org.il/MedicineIMAJ/viewarticle.aspx?aid=1021
Burns-Nader, S., & Hernandez-Reif, M. (2016). Facilitating play for hospitalized children
through child life services. Children's health care, 45(1), 1-21. DOI:
10.1080/02739615.2014.948161.
Gerber, G. (2012). Views on child life specialist training (Doctoral dissertation). Retrieved from
https://ttu-ir.tdl.org/handle/2346/45146
Haiat, H., Bar-Mor, G., & Shochat, M. (2003). The world of the child: a world of play even in
the hospital. Journal of Pediatric Nursing, 18(3), 209-214.
https://doi.org/10.1053/jpdn.2003.28
Kuntz, N., Adams, J. A., Zahr, L., Killen, R., Cameron, K., & Wasson, H. (1996). Therapeutic
play and bone marrow transplantation. Journal of pediatric nursing, 11(6), 359-367.
https://doi.org/10.1016/S0882-5963(96)80080-7
McGrath, P., & Huff, N. (2001). ‘What is it?’: findings on preschoolers’ responses to play with
medical equipment. Child: Care, Health and Development, 27(5), 451-462.
https://doi.org/10.1046/j.1365-2214.2001.00219.x
Mcleod, S. (n.d.). Erik Erkison’s Stages of Pyschosocial Development. Retrieved from

8. HDFS 2950 PLAY IN THE HOSPITAL 8
https://www.simplypyschology.org/Erik-Erikson.html.